COMMERCIAL LITIGATION INSURANCE PROPOSAL FORM

IMPORTANT NOTICE

1. You must complete this Proposal Form and have the information verified by your solicitor. All questions must be answered to enable a quotation to be given. Answer questions to the best of your knowledge, information and belief. The form must be signed and dated by both you and your solicitor. 2. Before an insurance contract is entered into you must provide information to AmTrust about your case. The information in this form and in material provided in support of it (either with or following it), should be provided after you have made reasonable searches and enquiries. This will include enquiries of third parties where possible or, if you are not an individual from persons within your organisation. AmTrust will assume the information is provided on this basis unless you put AmTrust on express notice that it is not. 3. The information should be provided in a reasonably clear and accessible way. AmTrust will not have notice of details which are provided within documentation but not specifically brought to AmTrust’s attention. 4. You must notify us in the event that there is any material change in the answers given to the questions contained in this Proposal Form. In such circumstances we may, at our sole discretion, modify or withdraw any outstanding quotation. 5. The full cover, terms, conditions, exclusions and limitations are contained within AmTrust’s Commercial Litigation Insurance Policy. 6. In this proposal “you/your” means the individual, company, partnership trust or association proposing for this insurance. “AmTrust” means AmTrust Europe Limited. 7. You should retain for your records a copy of the completed Proposal Form and details of any additional information provided. Please complete and sign this Proposal Form and return it to us together with a copy of the information requested at Section I. The completion and signature of this Proposal Form does not bind you or AmTrust to enter into a contract of insurance. Please take time to read and understand this note before completing this proposal form. When completing this form (and in providing any subsequent information) please be aware the purpose of asking these questions is to enable AmTrust to obtain the best information you have about the prospects of success of your claim, including any potential difficulties. This will enable AmTrust to make an informed assessment of your application for cover.

England & Wales

A: Information about you

How many applicants for cover are there?

Name of each applicant

Address of each applicant

Legal status of each applicant

Are you / will you be the claimant or the defendent?

B: Information about your representatives

Firm name

Date of instruction

Address

EPF registration number

Solicitor’s name

Supervisor / partner’s name

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B: Information about your representatives (continued)

Counsel’s name

Chambers

Expert’s name

Estimate of costs from outset to the end of the trial

Incurred Esimated TOTAL Cover Sought

Solicitors £ £ £ N/A

Own disbursements £ £ £ £

Counsel £ £ £ £

Total own costs estimate £ £ £ N/A

Esimate of Opponent’s costs £ £ £ £

Total cover sought N/A N/A N/A £

C: Costs estimates and cover sought - Please provide these summary details.

Have you provided an own costs budget to support the summary figures above? Please note the provision of such a budget would be a subjectivity of any quote.

Yes No

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D: Information about your opponent

How many opponents are there?

Name of each opponent

Address of each opponent

Legal status of each opponent

E: Information about your opponent’s representatives

Firm name

Address

Solicitor’s name

Supervisor / partner’s name

Counsel’s name

Chambers

Expert’s name

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F: Information about your claim / damages sought / settlement / prospects etc.

F.1 Claims / claim types and current stage

• What is the claim type? (E.g. breach of contract, professional negligence etc.)

• If there is more than one claim type, please give details of each.

When did the cause (or causes) of action arise?

When will the claim (or any of them if more than one) become statute barred for limitation purposes?

Are there any limitation issues?

Has there been pre-action protocol correspondence?

• Date of letter of claim? • Date of letter of response? If not please explain why (e.g. still collating information etc.).

Have proceedings been issued? If so, • In which court / tribunal, • what stage has been reached, and • Has the claim been allocated to a track? If not, in which court / tribunal is it envisaged the claim will be issued? Please give the action heading and number or the proposed action heading and court details.

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F.1 Claims / claim types and current stage (continued)

Do you envisage any pre action applications (with or without notice) or any interim applications including applications that include any third party?

Have dates been fixed for trial / first CMC / Costs Management Conference? • What needs to be established to succeed on liability and on quantum for each head of claim? • Please refer to any relevant statute and or case law.

Please provide details of any connected / parallel / overlapping litigation you are aware of whether you are involved in it or not.

Have you been involved (in either a personal or corporate capacity) in any litigation, arbitration or tribunal proceedings during the past 10 years? If so, please provide brief details.

F.2 Evidence

What evidence will be required to establish each claim and how will it be provided? Please provide brief comments on the importance of each of the following:• Documents • Witness evidence • Expert Evidence

What is the likely extent / importance of disclosure?

Are there any key documents that support the claim?

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F.2 Evidence (continued)

What will be the extent and importance of witness evidence including expert evidence? Who are the anticipated witnesses? Have draft statements been obtained?• Do you have the necessary evidence to support the claim (liability and quantum)? • If not what needs to be obtained and are could obtaining it prove problematic?

Is any of the evidence unhelpful and or is there a reason to anticipate unhelpful evidence may emerge?

F.3 Damages / Quantum

Assuming success on liability, what do you / your legal team consider to be, • The maximum extent of the claim / damages achievable (putting it at its highest). How has that figure been arrived at?

• The minimum extent (putting it at its lowest) of the claim / damages achievable. How has that figure been arrived at?

• The likely achievable sum (or range) on this claim/s? Please allow for the effect of any counterclaim when providing these numbers.

Are you making any claim that would not result in a financial award? If so, please provide details.

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F.4 Causation / remoteness / mitigation, contributory negligence etc.

Please highlight any potential issues and what points (if any) has or do you anticipate your opponent may raise?

F.5 Opponent’s response

Has the opponent provided any response to the claim/s? • Has a letter of response been received? • Has a defence been received? • Other? Please provide a brief synopsis of the defence position / anticipated position.

F.6 Counter claim

Is there a counterclaim or is a counterclaim envisaged?

If so is this a case where success on the claim will mean the counterclaim will fail and vice versa or what is the position?

F.7 Prospects

• Liability - what is your solicitor’s assessment of the likelihood of you succeeding in establishing liability on each separate head of claim and overall? • Quantum - with reference to the responses at E.3, what is your solicitor’s assessment of the prospects of you being awarded: (a) the maximum achievable amount, and (b) at least the minimum amount?

F.8 Settlement

What are your objectives and on what terms would you be prepared to settle? Provide details of any offers / judicial tenders of settlement made by you.Provide details of any offers / judicial tenders of settlement made by your opponent.

Would you be prepared to agree to mediate with your opponent? If not, why not?

F.9 Costs awards

Provide details of any costs orders made in the litigation /dispute to date.Assuming ‘success’ on all or part of the claim, is there any reason to think a costs award in your favour is likely to be reduced or that it is there is likely to be a split award of costs? (E.g. if a head of claim does not succeed or does not succeed against one or more of the opponents etc.)

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F.10 Enforcement prospects

What steps have you taken to ascertain the financial standing of your opponent to ensure that any award of damages or costs you may achieve will be met?

Please provide details of any assets of the opponent you have identified as likely to be available for the purpose of enforcement of any award in your favour.

If your opponent is or may be insured, please provide details of the information you have.

If you anticipate enforcement would include enforcement against property of the opponent, please provide a short summary schedule of the information you have on the property/properties including likely available equity.

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G: Funding / Costs

What funding arrangement do you have in place with your representatives? e.g. CFA

How is your opponent funding its legal costs?

What do you estimate your legal costs and disbursements (including any uplift under your CFA) will be to the conclusion of the trial? Please provide a step by step breakdown including any costs and disbursements you have already incurred on the attached template.

G: Funding / Costs (continued)

Have you filed a costs budget with the court? If so, please provide a copy. How do you propose to fund these costs?

What do you estimate your opponent’s legal costs will be to the conclusion of the trial?

Has the opponent filed a costs budget with the court? If so, please provide a copy.Do you have any other legal expenses insurance available to cover your costs and those of your opponent or any other parties in this litigation? Have you checked your position?

Have you approached any other insurer or broker in relation to this claim?

Has your solicitor advised you about funding this litigation and, if so, what advice have you received?

Has your solicitor advised that you are likely to face an application for security for costs?

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H: Other

Every claim is different. Are you or your solicitor aware of any aspect of your claim and its prospects of success and or the likelihood of your making a claim under any policy that has not been brought to our attention in the responses that you have provided above?

Yes / No If ‘Yes’ please provide us with details.

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I: Available documents

Signed proposal

X Comments

Your solicitor’s opinion together with a case summary

Counsel’s opinion

Particulars of Claim

Defence response

Any other statements of case served

Court orders to date

H: Other (continued)

Do you or your solicitor consider that any further information is required for a meaningful assessment of your claim at this time?

Yes / No If ‘Yes’ please provide us with details.

I: Available documents (continued)

Costs budgetCopies of any costs estimates that have been filed with the court. CFA with your representatives

Expert reports (including your Opponents’ if available)

Any report of any credit agency or similar in respect of the financial standing of your Opponent and any other evidence of the opponent’s financial position.

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Data Protection Any and all information supplied by you or on your behalf on or in connection with this Proposal Form and /or collected by AmTrust in connection with this Proposal Form (which information may include personal data, as defined by the Data Protection Act 1998 (the Act) and sensitive personal data, which is also defined by the Act and includes medical history and criminal convictions) will be held and used for some or all of the following purposes: • Processing your proposal form; • Administration (including claims handling); • Risk assessment; • Research and statistical purposes; and • Crime prevention

Your personal details will only be disclosed to third parties if it is necessary for the entering into and / or performance of your contract of insurance. By signing this Proposal Form you agree to your information being used in this way. We will keep your infor-mation secure at all times. In certain circumstances, for example for systems administration purposes we may have to transfer your information to another country, which may be a country outside the European Economic Area (EEA). By signing this proposal form you agree to the transfer of your information in these and similar circumstances to a country outside the EEA. Should you wish to receive a copy of the information we hold on you, please contact us at the address shown below: AmTrust Law AmTrust Europe Limited No 2 Minster Court Mincing Lane London EC3R 7BB

DECLARATION I declare that: (i) I have read the Data Protection Notice above and agree that my information (including any personal data and sensitive personal data) may be used as explained in that notice and may be transferred to a country outside the European Economic Area in the circumstances described above; and (ii) The contents of this proposal form are, to the best of my knowledge and belief, true and complete and that in presenting this proposal and supporting documentation and information I/we declare that I / we have taken reasonable care we that we have not made a misrepresentation and that the information provided represents a fair presentation of this risk, and I/we also confirm I / we have full authority to make this application. I will provide AmTrust with any additional information they require in order to consider my proposal for Commercial Litigation Insurance on condition that it is treated in confidence. I confirm that I and / or my legal representatives will meet with AmTrust to discuss my proposal should they request us to do so.

CLIENT

Date:Signed:

Status:

Name:

REPRESENTATIVE

Date:Signed:

Name:

Composite Legal Expenses Limited18 Park Place, Cardiff CF10 3DQ(t) +44 (0) 29 2022 2033 • www.composite-legal.comRegistered in England and Wales. Company Reg No. 3248183.Composite Legal Expenses Ltd is authorised and regulated by the Financial Conduct Authority (Firm Ref. No. 308979)CLECLIEAW00119072017

AmTrust International is a branding style of AmTrust Europe Limited. AmTrust Europe Limited, whose registered office is at Market Square House, St James’s Street, Nottingham, NG1 6FG, is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. These details can be checked on the Financial Services Register by visiting www.fca.org.uk